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1.
J Drugs Dermatol ; 18(9): 904-908, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31524346

RESUMO

Dermatologists are among the most inventive physicians, trained in the multiple disciplines of medical dermatology, surgical dermatology, and dermatopathology. Many of the advances in dermatology practice have been derived from inventive colleagues who identify opportunities for improvement in practice, develop viable prototypes to address these practice opportunities, and persevere through the hard work of developing new technologies to advance the practice of dermatology. In this article, we will review the basic elements of invention, patents, and the range of outcomes associated with the pursuit of invention. Examples of innovative dermatologic technologies and approaches will be reviewed. Opportunities abound for dermatologists to contribute to the advancement of medical care through invention in our specialty. J Drugs Dermatol. 2019;18(9):904-908.


Assuntos
Tecnologia Biomédica/métodos , Dermatologia/métodos , Invenções/legislação & jurisprudência , Dermatopatias/terapia , Tecnologia Biomédica/legislação & jurisprudência , Fármacos Dermatológicos/uso terapêutico , Dermatologistas , Dermatologia/instrumentação , Dermatologia/legislação & jurisprudência , Desenho de Equipamento , Humanos , Patentes como Assunto , Dermatopatias/diagnóstico
3.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(1): 20-27, ene.-feb. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-176882

RESUMO

La seguridad clínica y la responsabilidad profesional médica son hoy en día preocupaciones de primer orden en el ejercicio de la medicina. Interesa la valoración de las circunstancias en las que el ejercicio de la medicina no se ajusta a la lex artis, así como el impacto de las reclamaciones sobre los facultativos. Debe existir además un aprendizaje del error médico, identificando, mediante el estudio de reclamaciones, áreas específicas de mejora. La dermatología es una especialidad con bajo riesgo de reclamación a nivel internacional y también en nuestro contexto. Gran variedad de circunstancias clínicas dan lugar a reclamaciones por praxis médica en dermatología, y entre ellas destaca la actuación en caso de melanoma cutáneo maligno. Por otro lado, existen riesgos potenciales en las consultas de dermatología que merecen especial atención. El quehacer clínico está sujeto a un riesgo inherente de reclamación y por tanto son necesarias una serie de recomendaciones para prevenirlas


Clinical safety and medical liability are first-order concerns in today's medical practice. It is important to understand the circumstances under which medical acts fail to live up to the accepted standard of care and to recognize the impact that malpractice claims have on physicians. Practitioners must also grasp the concept of medical error, studying malpractice claims in order to identify the areas where improvement is needed. The risk of accusations of malpractice in dermatology is comparatively low, both in Spain and worldwide. However, a great variety of clinical scenarios in dermatology can potentially give rise to a claim, and malignant melanoma is most susceptible to risk. Dermatologists should know which actions during clinical consultation merit particular attention and care. Clinical practice carries inherent risk of malpractice claims, but taking certain recommended precautions can prevent them


Assuntos
Humanos , Dermatologia/ética , Dermatologia/legislação & jurisprudência , Dermatopatias/epidemiologia , Segurança do Paciente/legislação & jurisprudência , Melanoma/patologia , Terapia de Aceitação e Compromisso/métodos , Carcinoma de Célula de Merkel/patologia , Responsabilidade Social
7.
Actas Dermosifiliogr ; 110(1): 20-27, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30077393

RESUMO

Clinical safety and medical liability are first-order concerns in today's medical practice. It is important to understand the circumstances under which medical acts fail to live up to the accepted standard of care and to recognize the impact that malpractice claims have on physicians. Practitioners must also grasp the concept of medical error, studying malpractice claims in order to identify the areas where improvement is needed. The risk of accusations of malpractice in dermatology is comparatively low, both in Spain and worldwide. However, a great variety of clinical scenarios in dermatology can potentially give rise to a claim, and malignant melanoma is most susceptible to risk. Dermatologists should know which actions during clinical consultation merit particular attention and care. Clinical practice carries inherent risk of malpractice claims, but taking certain recommended precautions can prevent them.


Assuntos
Dermatologia/legislação & jurisprudência , Imperícia/legislação & jurisprudência , Segurança do Paciente/legislação & jurisprudência , Humanos , Guias de Prática Clínica como Assunto , Espanha
10.
Australas J Dermatol ; 59(3): 168-170, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29292506

RESUMO

A research team at Stanford recently reported that their deep convolutional neural network had learned to classify skin cancer with a level of competence equivalent to that of board-certified dermatologists. It is possible that in time, and using larger datasets, such software may surpass the average doctor in diagnostic ability, and that highly accurate technology may be available to both clinicians and patients via smartphones. This technology is poised to change the landscape of skin cancer diagnosis for both physicians and patients, but whether such changes are beneficial will depend on how they are regulated and implemented.


Assuntos
Dermatologia/métodos , Interpretação de Imagem Assistida por Computador , Aplicativos Móveis , Papel do Médico , Neoplasias Cutâneas/diagnóstico por imagem , Dermatologia/legislação & jurisprudência , Autoavaliação Diagnóstica , Humanos , Responsabilidade Legal , Aplicativos Móveis/legislação & jurisprudência , Smartphone
11.
JAMA Dermatol ; 154(2): 160-166, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29214284

RESUMO

Importance: Recognizing malpractice trends in the field of dermatology is important for establishing safeguards for patient care and minimizing liability. However, there is a lack of published data on malpractice claims against dermatologists. Objective: To determine characteristics of medical professional liability claims in the field of dermatology and to compare these claims with those against all physicians. Design, Setting, and Participants: We examined malpractice liability data collected on dermatologists and other physicians insured by companies that report data to the Physician Insurers Association of America Data Sharing Project (PIAA-DSP), a nationally representative liability claims registry. Data analyzed spanned the years 1991 through 2015. Main Outcomes and Measures: Demographic characteristics of dermatologists subject to claims, characteristics of closed claims, medical errors associated with closed claims, and patient outcomes leading to closed claims. Results: Data on a total of 90 743 closed claims were analyzed, 1084 (1.2%) against dermatologists and 89 659 (98.8%) against nondermatologists. More lawsuits were brought against male (n = 753, 69.5%) than female dermatologists (n = 270, 24.9%); 5.6% of claims (n = 61) did not identify the physician's sex. Full-time practitioners (n = 1035, 95.5%) and those in solo practice (n = 600, 55.4%) were more likely to be sued than those in group practices (n = 429, 39.6%) and institutions (n = 31, 2.9%). Most claims against dermatologists were abandoned, withdrawn, or dismissed (n = 735, 67.8%). Between 2006 and 2015, trial verdicts favoring defendants exceeded trial verdicts favoring plaintiffs by a factor of 7. Errors that occurred during a procedure spawned the most claims (n = 305), of which 102 were paid. Misdiagnoses comprised the second-highest number of claims (n = 192), of which 62 were paid. The average recovery per claim was $238 145. The most common procedure leading to claims was skin operations (420 claims, of which 130 were paid). The most common adverse patient outcome associated with claims was dyschromia, resulting in 171 claims, of which 40 were paid. Conclusions and Relevance: Male dermatologists were sued more often than female dermatologists. Overall, alleged errors in procedures and misdiagnosis gave rise to the most lawsuits. Dyschromia was the most common adverse outcome alleged in lawsuits.


Assuntos
Dermatologistas/legislação & jurisprudência , Responsabilidade Legal , Imperícia/estatística & dados numéricos , Padrões de Prática Médica/legislação & jurisprudência , Competência Clínica , Bases de Dados Factuais , Dermatologia/legislação & jurisprudência , Feminino , Humanos , Revisão da Utilização de Seguros , Masculino , Erros Médicos/estatística & dados numéricos , Médicas/estatística & dados numéricos , Estudos Retrospectivos , Medição de Risco , Estados Unidos
12.
Australas J Dermatol ; 59(2): 101-107, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-28247404

RESUMO

BACKGROUND: Smartphones are rapidly changing the way doctors capture and communicate clinical information, particularly in highly visual specialties such as dermatology. An understanding of how and why smartphones are currently used in clinical practice is critical in order to evaluate professional and legal risks, and to formulate policies that enable safe use of mobile technologies for the maximal benefit of practitioners and patients. METHODS: Australian dermatologists and dermatology trainees were surveyed on their current practices relating to clinical smartphone use. RESULTS: Of the 105 respondents, 101 provided useable results. The data show clinical smartphone use is common and frequent, with more than 50% of respondents sending and receiving images on their smartphones at least weekly. Clinical photographs were usually sent via multimedia message or email and were commonly stored on smartphones (46%). Security measures adopted to protect data were limited. There was inadequate documentation of consent for transmission of photographs and advice provided. Only 22% of respondents were aware of clear policies in their workplace regarding smartphone use, and a majority desired further education on digital image management. CONCLUSIONS: Given the frequency of use and the degree of importance placed on the ability to send and receive clinical images, clinical smartphone use will persist and will likely increase over time. Current practices are insufficient to comply with professional and legal obligations, and increase practitioners' vulnerability to civil and disciplinary proceedings. Further education, realistic policies and adequate software resources are critical to ensure protection of patients, practitioners and the reputation of the dermatological profession.


Assuntos
Dermatologia/instrumentação , Fotografação/instrumentação , Padrões de Prática Médica/estatística & dados numéricos , Smartphone/estatística & dados numéricos , Austrália , Confidencialidade , Dermatologia/legislação & jurisprudência , Documentação , Humanos , Consentimento Livre e Esclarecido , Política Organizacional , Fotografação/legislação & jurisprudência , Registros , Encaminhamento e Consulta , Inquéritos e Questionários
13.
Clin Dermatol ; 35(6): 612-615, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29191354

RESUMO

Alliances are necessary for the development of individuals, institutions, and civilizations. Optimally, alliances provide benefits to their components; nevertheless, gains are not always symmetrical. Some alliances may prove detrimental or even lethal to some or all of the allies. I analyze some types of covenants using examples of history to provide a framework for drawing salient features of the alliance between the legal and the medical professions. This joint effort should be inherently beneficial to both; yet, particularly in the United States, the equilibrium is skewed against the medical profession. If it is not redressed, medicine and its specialties-in particular, dermatology-will go into a decline and wilt.


Assuntos
Comportamento Cooperativo , Cooperação Internacional/história , Jurisprudência , Legislação Médica , Medicina , Dermatologia/legislação & jurisprudência , História do Século XV , História do Século XVI , História Antiga , História Medieval , Humanos
14.
J Dtsch Dermatol Ges ; 15(11): 1103-1109, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29064628

RESUMO

BACKGROUND AND OBJECTIVES: "Off-label use" is defined as the prescription of pharmaceutical products outside their approved indications. Rare diseases frequently lack "on-label" treatment options. In order to avoid reimbursement claims following the prescription of off-label drugs, physicians in Germany can - on a case-by-case basis - file an application for cost coverage with the competent health insurance prior to treatment initiation. PATIENTS AND METHODS: We conducted a chart review for cost coverage requests submitted by two outpatient clinics at a university-affiliated dermatology department between 2010 and 2012 (clinic for autoimmune diseases and urticaria clinic). Insurance providers, acceptance rates, reasons for rejection, and processing times were analyzed. RESULTS: The analysis showed that 56.8 % of applications for off-label use (n = 44) were approved during the first round. The rate increased to 75.0 % when including approvals granted after up to two rejections. The time between initial application and the response of health insurers was 49 days (median). In case of cost coverage approval, treatments were initiated 92 days (median) after the initial request. CONCLUSIONS: The present case series shows that, in the majority of cases, health insurers in Germany have agreed to reimburse the costs of proposed off-label therapies. A prospective study is required in order to evaluate whether current changes to legal regulations (GKV-Versorgungsstrukturgesetz, Patientenrechtegesetz) adequately address the problems identified.


Assuntos
Dermatologia/legislação & jurisprudência , Programas Nacionais de Saúde/legislação & jurisprudência , Uso Off-Label/legislação & jurisprudência , Mecanismo de Reembolso/legislação & jurisprudência , Dermatologia/economia , Alemanha , Humanos , Revisão da Utilização de Seguros/economia , Revisão da Utilização de Seguros/legislação & jurisprudência , Cobertura do Seguro/economia , Cobertura do Seguro/legislação & jurisprudência , Programas Nacionais de Saúde/economia , Uso Off-Label/economia , Mecanismo de Reembolso/economia , Estudos Retrospectivos
18.
Am J Clin Dermatol ; 17(6): 601-607, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27785707

RESUMO

Facing a malpractice lawsuit can be a daunting and traumatic experience for healthcare practitioners, with most clinicians naïve to the legal landscape. It is crucial for physicians to know and understand the malpractice system and his or her role once challenged with litigation. We present part II of a two-part series addressing the most common medicolegal questions that cause a great deal of anxiety. Part I focused upon risk-management strategies and prevention of malpractice lawsuits, whereas part II provides helpful suggestions and guidance for the physician who has been served with a lawsuit complaint. Herein, we address the best approach concerning what to do and what not to do after receipt of a legal claim, during the deposition, and during the trial phases. We also discuss routine concerns that may arise during the development of the case, including the personal, financial, and career implications of a malpractice lawsuit and how these can be best managed. The defense strategies discussed in this paper are not a guide separate from legal representation to winning a lawsuit, but may help physicians prepare for and cope with a medical malpractice lawsuit. This article is written from a US perspective, and therefore not all of the statements made herein will be applicable in other countries. Within the USA, medical practitioners must be familiar with their own state and local laws and should consult with their own legal counsel to obtain advice about specific questions.


Assuntos
Dermatologistas/psicologia , Dermatologia/legislação & jurisprudência , Seguro de Responsabilidade Civil , Imperícia/legislação & jurisprudência , Relações Médico-Paciente , Dermatologistas/economia , Dermatologistas/legislação & jurisprudência , Documentação , Humanos , Relações Interprofissionais , National Practitioner Data Bank , Guias de Prática Clínica como Assunto , Relações Profissional-Família , Estados Unidos
19.
Am J Clin Dermatol ; 17(6): 593-600, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27734331

RESUMO

Malpractice risk is a common source of concern for the practicing physician. Dermatologists experience fewer lawsuits than most other specialists in medicine, but the risk is not negligible. All physicians should familiarize themselves with areas of potential risk and avoid medico-legal pitfalls. We present Part I of a two-part series addressing medico-legal questions common to most practitioners that cause a great deal of anxiety. Part I will focus upon risk management and prevention of future malpractice lawsuits, and Part II deals with suggestions and guidance once a lawsuit occurs. Herein, we discuss the primary sources of malpractice lawsuits delivered against healthcare practitioners including issues with informed consent, patient noncompliance, medical negligence, and inappropriate documentation, including use of electronic medical records. The overall goal is to effectively avoid these common sources of litigation. The risk management strategies discussed in this paper are relevant to the everyday practitioner and may offer physicians some degree of protection from potential liability.


Assuntos
Dermatologia/organização & administração , Consentimento Livre e Esclarecido/legislação & jurisprudência , Imperícia/legislação & jurisprudência , Erros Médicos/legislação & jurisprudência , Cooperação do Paciente , Gestão de Riscos/métodos , Dermatologia/legislação & jurisprudência , Documentação , Registros Eletrônicos de Saúde/legislação & jurisprudência , Humanos , Guias de Prática Clínica como Assunto , Telemedicina/legislação & jurisprudência , Estados Unidos
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